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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (COSTA RICA) STYLE 68 SALINE FILLED BREAST IMPLANT; PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE

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ALLERGAN (COSTA RICA) STYLE 68 SALINE FILLED BREAST IMPLANT; PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE Back to Search Results
Catalog Number 68HP-425
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code Failure of Implant (1924)
Date of Event 02/09/2026
Type of Reportable Event Serious Injury
Event or Problem Description
Patient reported ¿deflation¿.Later healthcare professional reported "deflation".This record is for the right side.Device remains implanted.
 
Additional Manufacturer Narrative
A review of the device history record has been completed.No deviations or non-conformances noted.Further information from the reporter regarding event, product, or patient details has been requested.No additional information is available at this time.Reason for reoperation: deflation.
 
Additional Manufacturer Narrative
Additional, corrected and/or changed data: b.5, d.6b, h.6.
 
Event or Problem Description
Patient reported ¿deflation¿.Later healthcare professional reported "deflation".This record is for the right side.Device has been explanted.
 
Additional Manufacturer Narrative
Additional, changed, and/or corrected data: b5, d4, d6b, d9, h3, h6.Device evaluation: per the analysis performed, the assessments of the complaints and any potential manufacturing issue are displayed along with any further actions required: - deflation: observed 3 openings through microscopic inspection assessed as fold flaw opening.No further actions are required as it is not related to the manufacturing process.None of the other observations performed during the device analysis (creases, wear abrasion) are found to be potentially related to the manufacturing process, and, therefore, no further actions are required for these observations.
 
Event or Problem Description
Device has been explanted and replaced.
 
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Brand Name
STYLE 68 SALINE FILLED BREAST IMPLANT
Common Device Name
PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE
Manufacturer (Section D)
ALLERGAN (COSTA RICA)
900 parkway global park
zona franca
la aurora de heredia
CS 
Manufacturer (Section G)
ALLERGAN (COSTA RICA)
900 parkway global park
zona franca
la aurora de heredia
CS  
Manufacturer Contact
terry ingram
2525 dupont drive
irvine, CA 92612
8479366324
MDR Report Key24408240
Report Number9617229-2026-03388
Device Sequence Number9859299
Product Code FWM
UDI-Device Identifier10888628000421
UDI-Public(01)10888628000421(17)091105(21)11757055
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P990074
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2006
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Consumer,Health Professional
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 06/10/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Expiration Date11/05/2009
Device Catalogue Number68HP-425
Device Lot Number1175506
Was Device Available for Evaluation? Device Returned to Manufacturer
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/05/2026
Supplement Date Received by Manufacturer03/27/2026
05/15/2026
Initial Report FDA Received Date02/20/2026
Supplement Report FDA Received Date04/20/2026
06/10/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/15/2005
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age57 YR
Patient SexFemale
Patient Weight63 KG
Patient EthnicityNon Hispanic
Patient RaceWhite
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